In a Cape Cod workers’ compensation case, the issues can be numerous. Typical issues include the amount of temporary benefits due the worker, the extent of the worker’s permanent disability, and the worker’s entitlement to medical care for his or her injuries.
Sometimes, contention begins even earlier in the process, with the employer or its insurance company denying the worker’s claim. As grounds, the employer or carrier may claim that the injury did not happen in the course and scope of the employee’s work or that some other defense (such as intoxication on the job) may apply.
In still other cases, the dispute may be even more fundamental. Was there workers’ compensation insurance in effect at the time of the accident in question?
Facts of the Case
In a recent workers’ compensation case considered on appeal by the Massachusetts Appeals Court, the claimants were two men who were injured on a construction project while working for a demolition subcontractor in 2016. Prior to the accident giving rise to the litigation, the subcontractor had multiple workers’ compensation insurance policies canceled due to nonpayment of the premiums. The most recent policy, which would have been in effect at the time of the accident under its original terms, was cancelled about four months prior to the claimants’ accident.
The claimants sought compensation from both the subcontractor’s workers’ compensation carrier and the general contractor’s workers’ compensation carrier. An administrative law judge ordered the general contractor’s carrier to pay the claims, but a reviewing judge determined that the subcontractor’s workers’ compensation carrier had not effectively canceled the subcontractor’s policy and concluded that the subcontractor’s workers’ compensation carrier was responsible for the claims. The reviewing board summarily affirmed.
The Court’s Decision
The Massachusetts Appeals Court vacated the lower tribunal’s decision and remanded the case for further proceedings. Because Massachusetts General Laws ch. 152, § 65B, did not require the subcontractor’s workers’ compensation insurance carrier to mail its cancellation of the subcontractor’s policy via certified mail, return receipt requested, the lower tribunal erroneously held that the cancellation was ineffective. Rather, in the appellate court’s view, the insurer had a right to rely “at least in the first instance” upon a certification that it mailed the notice by first class mail to the insured’s address.
Because the administrative law judge did not consider whether the insurer’s prima facie evidence of delivery might be rebutted, the reviewing board was to consider that issue on remand.
To Speak to a Massachusetts Trial Attorney
In most Cape Cod workers’ compensation cases, the employer’s workers’ compensation insurance carrier does not dispute coverage but, instead, either avers that the employee’s claim was not compensable or that he or she did not suffer any permanent disability from the accident or injury at issue. However, coverage disputes are not unheard of, and it is important to have a legal advocate in your corner should this or another issue arise during your case. To speak to a member of our staff about your situation, call the Law Offices of John C. Manoog III at 888-262-6664 and ask for a free consultation. We’ll be glad to help!